Disseminated fusariosis emerged from prolonged local genital infection after cord blood transplantation

J Infect Chemother. 2018 Aug;24(8):660-663. doi: 10.1016/j.jiac.2017.12.018. Epub 2018 Jan 17.

Abstract

Disseminated fusariosis (DF) is a rare life threatening fungal infection in immunocompromised hosts. We herein report a case of a fatal DF mimicking varicella zoster virus (VZV) infection that was emerged from a localized genital infection during cord blood transplantation (CBT) in a patient with severe aplastic anemia (SAA). The patient developed an ulcer following small painful vesicles mimics herpes simplex virus infection (HSV) on the glans penis before CBT, but a Fusarium species was identified. Despite administration of voriconazole, liposomal amphotericin B and granulocyte transfusion, the lesion was extended to extensive skin looked like VZV infection and the patients died after CBT. Massive fusarium infiltration was detected in multiple organs at autopsy. A genetic analysis of the mold identified Fusarium solani after his death. It should be noted that in patients with fusarium infection, localized and disseminated lesions of fusarium infection sometimes mimic HSV and VZV infections, which hampers an early diagnosis.

Keywords: Disseminated fusarium infection; Fusarium solani; Genital herpes; Hematopoietic stem cell transplantation; Herpes simplex virus; Varicella zoster virus.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anemia, Aplastic / therapy*
  • Antifungal Agents / therapeutic use
  • Antiviral Agents
  • Cord Blood Stem Cell Transplantation / adverse effects*
  • Diagnosis, Differential
  • Fatal Outcome
  • Fetal Blood / transplantation
  • Fusariosis / diagnosis
  • Fusariosis / drug therapy
  • Fusariosis / immunology*
  • Fusariosis / microbiology
  • Fusarium / isolation & purification
  • Herpesvirus 3, Human / isolation & purification
  • Humans
  • Immunocompromised Host*
  • Male
  • Penis / microbiology
  • Time Factors
  • Transplantation, Homologous / adverse effects
  • Varicella Zoster Virus Infection / diagnosis
  • Varicella Zoster Virus Infection / drug therapy

Substances

  • Antifungal Agents
  • Antiviral Agents